| 引用本文: |
唐迎港,蔺婷,蒋益兰,王贤文,何迎春.基于五行制化失调探析肺积病机及辨治[J].湖南中医药大学学报,2023,43(6):1117-1122[点击复制] |
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| 基于五行制化失调探析肺积病机及辨治 |
| 唐迎港,蔺婷,蒋益兰,王贤文,何迎春 |
| (湖南中医药大学, 湖南 长沙 410208;湖南省中西医结合医院, 湖南 长沙 410006;湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 从五行制化失调理论探析肺积病机及临证辨治。肺积包括临床常见的肺结节及肺癌，肺积病变的病位主要在肺，与脾、肾、肝密切相关；主要病理因素为虚、痰、瘀、毒；病理性质为本虚标实，虚实夹杂，肺虚为本，并见脾虚或肾虚，有形实邪结聚为标；基本病机为肺虚蕴毒，制化失调，痰浊凝聚，瘀血内结；病情进展的关键病机为肺虚蕴毒，脏腑失调，湿邪夹毒，或湿邪夹癌毒，或瘀毒胶着，随气流行，循脉入络，痼结虚藏。其基本治法为攻补兼施、解毒散结、痰瘀同治。肺结节临证予分期论治；肺癌临证予益肺健脾补肾以培育根本，祛痰化瘀散结以根除痼结，行气利湿解毒以防治传舍，泻肺化饮息风以治标缓急，从而恢复五藏间协调平衡状态，防止疾病传变。从五行整体思路分析肺积病机及辨治，可资临床应用。 |
| 关键词: 五行制化失调|肺积|肺结节|肺癌|攻补兼施|解毒散结|痰瘀同治 |
| DOI：10.3969/j.issn.1674－070X.２０23.06.025 |
| 投稿时间：2023-02-19 |
| 基金项目:国家自然科学基金项目（81973914）；“刘良院士工作站”指导项目（22YS001）；湖南省教育厅资助项目（21A0229，21C0234）；基础医学双一流专项（6001002）。 |
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| Exploration of pathogenesis, pattern identification and treatment of pulmonary masses based on “imbalanced mutual generation and restriction among the five elements” |
| TANG Yinggang,LIN Ting,JIANG Yilan,WANG Xianwen,HE Yingchun |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Hunan Provincial Hospital of Integrated Chinese and Western Medicine, Changsha, Hunan 410006, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| To explore the pathogenesis, pattern identification and treatment of pulmonary masses from the theory of “imbalanced mutual generation and restriction among the five elements”. Pulmonary masses often manifest as pulmonary nodules and lung cancer in clinic, of which the disease location is mainly in the lung and is closely related to the spleen, kidneys, and liver. With the main pathological factors of deficiency, phlegm, blood stasis and toxin, the pathological nature of this disease is mixed deficiency in root and excess in manifestation. Lung deficiency is the root and spleen or kidney deficiency is also present, while the tangible excess pathogens accumulating in the lungs are the manifestations. The basic pathogenesis is that lung deficiency combined with toxin accumulation results in imbalanced mutual generation and restriction among the five elements (the five zang-organs), and then the phlegm, blood stasis, and toxin accumulate in the lungs. The key pathogenesis in the progress of the disease is that lung deficiency results in toxin accumulation and dysfunctional zang-fu organs, leading to dampness complicated with toxin or cancer toxin, or blood stasis combined with toxin, then spreading along the qi flow, entering the vessels and collaterals, finally forming chronic stagnation in the deficient lungs. Therefore, the basic therapeutic methods for pulmonary masses are reinforcing healthy qi and removing pathogenic factors simultaneously, removing toxins and resolving nodules as well as synchronically treating phlegm and blood stasis. In addition, pulmonary nodules are often treated with stage differentiation in clinical practice. And the clinical treatment of lung cancer is to benefit the lung, strengthen the spleen, and tonify the kidney for cultivating the foundation; to resolve phlegm, transform stasis for eradicating obstinate nodules; to regulate qi, drain dampness, and remove toxins for preventing and treating cancer metastasis; to drain the lung, transform water retention, and extinguish wind for treating symptoms in acute condition and treating the root in chronic case. Then it can restore the balanced mutual generation and restriction among the five elements and prevent the development and metastasis of lung cancer. Therefore, it is clinically applicable to analyze the pathogenesis, pattern identification and treatment of pulmonary masses from overall thinking of the five elements. |
| Key words: imbalanced mutual generation and restriction among the five elements|pulmonary masses|pulmonary nodules|lung cancer|reinforcing healthy qi and removing pathogenic factors simultaneously|removing toxins and resolving masses|synchronically treating phlegm and blood stasis |
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